scholarly journals Mechanism of Injury, Glasgow Coma Scale, Age, and Systolic Blood Pressure: A New Trauma Scoring System to Predict Mortality in Trauma Patients

2015 ◽  
Vol 20 (3) ◽  
Author(s):  
Iraj Baghi ◽  
Leila Shokrgozar ◽  
Mohamad Rasoul Herfatkar ◽  
Kazem Nezhad Ehsan ◽  
Zahra Mohtasham Amiri
Keyword(s):  
Blood Pressure ◽  
Glasgow Coma Scale ◽  
Systolic Blood Pressure ◽  
Scoring System ◽  
Trauma Patients ◽  
Mechanism Of Injury ◽  
Coma Scale ◽  
Trauma Scoring

scholarly journals Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, Age, and Systolic Blood Pressure score

Critical Care ◽  
2011 ◽  
Vol 15 (4) ◽  
pp. R191 ◽  
Author(s):  
Yutaka Kondo ◽  
Toshikazu Abe ◽  
Kiyotaka Kohshi ◽  
Yasuharu Tokuda ◽  
E Francis Cook ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Glasgow Coma Scale ◽  
Hospital Mortality ◽  
Systolic Blood Pressure ◽  
Scoring System ◽  
Coma Scale ◽  
Trauma Scoring

scholarly journals Derivation and validation of an easy-to-compute trauma score that improves prognostication of mortality or the Trauma Rating Index in Age, Glasgow Coma Scale, Respiratory rate and Systolic blood pressure (TRIAGES) score

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Atsushi Shiraishi ◽  
Yasuhiro Otomo ◽  
Shunsuke Yoshikawa ◽  
Koji Morishita ◽  
Ian Roberts ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glasgow Coma Scale ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Validation Cohort ◽  
Hospital Death ◽  
The Novel ◽  
Coma Scale ◽  
Physiological Variables ◽  
Trauma Score

Abstract Background Multiple trauma scores have been developed and validated, including the Revised Trauma Score (RTS) and the Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP) score. However, these scores are complex to calculate or have low prognostic abilities for trauma mortality. Therefore, we aimed to develop and validate a trauma score that is easier to calculate and more accurate than the RTS and the MGAP score. Methods The study was a retrospective prognostic study. Data from patients registered in the Japan Trauma Databank (JTDB) were dichotomized into derivation and validation cohorts. Patients’ data from the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial were assigned to another validation cohort. We obtained age and physiological variables at baseline, created ordinal variables from continuous variables, and defined integer weighting coefficients. Score performance to predict all-cause in-hospital death was assessed using the area under the curve in receiver operating characteristics (AUROC) analyses. Results Based on the JTDB derivation cohort (n = 99,867 with 12.5% mortality), the novel score ranged from 0 to 14 points, including 0–2 points for age, 0–6 points for the Glasgow Coma Scale, 0–4 points for systolic blood pressure, and 0–2 points for respiratory rate. The AUROC of the novel score was 0.932 for the JTDB validation cohort (n = 76,762 with 10.1% mortality) and 0.814 for the CRASH-2 cohort (n = 19,740 with 14.6% mortality), which was superior to RTS (0.907 and 0.808, respectively) and MGAP score (0.918 and 0.774, respectively) results. Conclusions We report an easy-to-use trauma score with better prognostication ability for in-hospital mortality compared to the RTS and MGAP score. Further studies to test clinical applicability of the novel score are warranted.

Should Trauma Patients with a Glasgow Coma Scale Score of 3 Be Intubated Prior to Hospital Arrival?

2010 ◽  
Vol 25 (6) ◽  
pp. 541-546 ◽  
Author(s):  
Charlene B. Irvin ◽  
Susan Szpunar ◽  
Lauren A. Cindrich ◽  
Justin Walters ◽  
Robert Sills
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Logistic Regression ◽  
Glasgow Coma Scale ◽  
Systolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Body Region ◽  
Trauma Patients ◽  
Hospital Arrival ◽  
Prehospital Endotracheal Intubation

AbstractIntroduction:Previous studies of heterogeneous populations (Glasgow Coma Scale (GCS) scores <9) suggest that endotracheal intubaton of trauma patients prior to hospital arrival (i.e., prehospital intubated) is associated with an increased mortality compared to those patients not intubated in the pre-hospital setting. Deeply comatose patients (GCS = 3) represent a unique population of severely traumatized patients and may benefit from intubation in the prehospital setting. The objective of this study was to compare mortality rates of severely comatose patients (scene GCS = 3) with prehospital endotracheal intubation to those intubated at the hospital.Methods:Using the National Trauma Data Bank (V. 6.2), the following variables were analyzed retrospectively: (1) age; (2) injury type (blunt or penetrating); (3) Injury Severity Score (ISS); (4) scene GCS = 3 (scored prior to intubation/without sedation); (5) emergency department GCS score; (6) arrival emergency department intubation status; (7) first systolic blood pressure in the emergency department (>0); (8) discharge status (alive or dead); (9) Abbreviated Injury Scale Score (AIS); and (10) AIS body region.Results:Of the 10,948 patients analyzed, 23% (2,491/10,948) were endotracheally intubated in a prehospital setting. Mortality rate for those hospital intubated was 35% vs. 62% for those with prehospital intubation (p <0.0001); mean ISS scores 24.2 ±16.0 vs. 31.6 ±16.2, respectively (p <0.0001). Using logistic regression, controlling for first systolic blood pressure, ISS, emergency department GCS, age, and type of trauma, those with prehospital intubation were more likely to die (OR = 1.9, 95% CI = 1.7−2.2). For patients with only head AIS scores (no other body region injury, n = 1,504), logistic regression (controlling for all other variables) indicated that those with prehospital intubation were still more likely to die (OR = 2.0. 95% CI = 1.4−2.9).Conclusions:Prehospital endotracheal intubation is associated with an increased mortality in completely comatose trauma patients (GCS = 3). Although the exact reasons for this remain unclear, these results support other studies and suggest the need for future research and re-appraisal of current policies for prehospital intubation in these severely traumatized patients.

scholarly journals Mortality Prediction in Trauma Patients using Three Different Physiological Trauma Scoring Systems

2017 ◽  
Vol 6 (3) ◽  
pp. 160-168
Author(s):  
Danilo M Razente ◽  
Bruno D Alvarez ◽  
Daniel AM Lacerda ◽  
João MDS Biscardi ◽  
Marcia Olandoski ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Blunt Trauma ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Trauma Patients ◽  
Coma Scale ◽  
Significant Difference ◽  
Trauma Scoring ◽  
The Mean ◽  
Trauma Victims

ABSTRACT Background This study aims to compare mortality prediction capabilities of three different physiological trauma scoring systems (TSS): Revised Trauma Score (RTS) Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP) and Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP). Study design A descriptive, cross-sectional study of trauma victims admitted to the emergency service between December-2013 and February-2014. Clinical and epidemiological information were gathered at admission and three TSS were calculated: RTS, GAP, and MGAP. The follow-up period to assess length of hospitalization and mortality lasted until August-2014. Two groups were created — survivals (S) and deaths (D) — and compared. P < 0.05 was considered statistically significant. Results A total of 668 trauma victims were analyzed. The mean age was 37 ± 18 and 69.8% were males. Blunt trauma prevailed (90.6%). The mean scores of RTS, GAP, and MGAP for group S (n = 657; 98.4%) were 7.77 ± 0.33, 22.8 ± 1.7, and 27.4 ± 2.3 respectively (p < 0.001), whereas group D (n = 11, 1.6%) achieved mean scores of 4.57 ± 2.95, 13 ± 7, and 15.5 ± 7 (p < 0.001). Regarding the Receiver Operating Characteristics (ROC) analysis, the areas under the curve were 0.926 (RTS), 0.941 (GAP), and 0.981 (MGAP). The three TSS demonstrated significant mortality prediction capabilities (p < 0.001). There was no statistically significant difference between the three ROC curves (p = 0.138). The MGAP achieved the highest sensitivity (100%), while GAP and RTS sensitivities were 81.8% (59—100%), and 90.9% (73.9—100%) respectively (p < 0.001). The observed specificities were 96.2% (94.77—97.7%) for GAP, 91.6% (89.5—93.7%) for MGAP, and 87.2% (84.7—89.8%) for RTS (p < 0.001). Age (p = 0.049), Glasgow Coma Scale (GCS) (p < 0.001), and trauma mechanism (p < 0.001) were different between the two groups. Conclusion Most patients were young males and victims of blunt trauma. The three TSS demonstrated reliability regarding mortality prediction. The MGAP achieved the highest sensitivity and GAP was the most specific score, which may indicate a potential use of both as valuable alternatives to RTS. How to cite this article Razente DM, Alvarez BD, Lacerda DAM, Biscardi JMDS, Olandoski M, Bahten LCV. Mortality Prediction in Trauma Patients using Three Different Physiological Trauma Scoring Systems. Panam J Trauma Crit Care Emerg Surg 2017;6(3):160-168.

scholarly journals Prospective Evaluation of a Protocol of Whole Body CT based only in Mechanism of Injury in Major Trauma Patients

2015 ◽  
Vol 4 (2) ◽  
pp. 66-69
Author(s):  
Eduardo Rissi Silva ◽  
Felipe Rossi ◽  
Newton Djin Mori ◽  
Diogo FV Garcia ◽  
Edvaldo Utiyama
Keyword(s):  
Glasgow Coma Scale ◽  
Major Trauma ◽  
Clinical Findings ◽  
Whole Body ◽  
Trauma Patients ◽  
Mechanism Of Injury ◽  
Prospective Evaluation ◽  
Coma Scale ◽  
Whole Body Ct ◽  
Body Ct

ABSTRACT Background There is an important increase in the use of whole body computed tomography (WBCT) around the world although its benefits are still controversial. We hypothesized that the use of a WBCT protocol in the major trauma patients based on mechanism of injury alone would reduce the number of injuries that would have been missed if CT was only done based on clinical findings. Study design A prospective observational study with the inclusion of 144 patients with major blunt trauma during 5 months at our academic center. Data were collected from all patients including: epidemiology, clinical status on scene and at the emergency department, time of the scan (including patient handling), clinical findings during initial assessment and WBCT scan findings, dividing exams in with or without findings (normal). Looking for findings that would go unnoticed if CT was done based on clinical findings. Glasgow coma scale (GCS) 15 and GCS <15 were compared and data are presented as absolute values of mean ± SD. Analysis of data was done with Chi-square test (p < 0.05). Results One hundred forty-four patients with major trauma that were included in the protocol. Normal CT scan was found in 44 cases and 100 scans had at least one positive finding associated with the trauma and 35 CTs (25%) had at least one injury that would be missed without the WBCT protocol. Glasgow coma scale of 15 patients and those with 14 or less were compared regarding the number of normal vs positive scan (p = 0.45) and for scans with unnoticed injuries (p = 0.1) and there was no difference between the two groups. Conclusion A significant number of injuries would have been missed if a WBCT scan protocol based on mechanism of injury was not used in our center. There was no difference in the number of probably missed injuries in patients with a GCS = 15 or those with GCS ≤14. How to cite this article Silva ER, Rossi F, Mori ND, Garcia DFV, Utiyama E. Prospective Evaluation of a Protocol of Whole Body CT based only in Mechanism of Injury in Major Trauma Patients. Panam J Trauma Crit Care Emerg Surg 2015;4(2):66-69.

Mortality Prediction of MGAP Scoring System (type of injury, GCS, age, and systolic blood pressure) in Trauma Patients

2015 ◽  
Vol 20 (Special Issue) ◽  
Author(s):  
Iraj Baghi ◽  
Leila Shokrgozar ◽  
Mohamad Rasoul Herfatkar ◽  
Ehsam Kazem-Nezhad ◽  
Zahra Mohtasham-Amiri
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Scoring System ◽  
Mortality Prediction ◽  
Trauma Patients ◽  
System Type ◽  
Type Of Injury
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